April 23, 2009

Riddle Me This

What is a greater threat to public health, infectious disease or autism?

Former Playboy model Jenny McCarthy and erstwhile pet detective Jim Carrey would rather your child die from infectious disease than have autism. (This even though Ms. McCarthy’s son was “cured” of the disorder.) Mr. Carrey wrote a column for the Huffington Post yesterday demanding more studies of vaccine safety and ignoring scientific and logical evidenceconcluding vaccinations do not cause autism. This position has very real consequences for public health. The more unvaccinated people there are, the more likely an epidemic is to occur. It’s not just a personal choice whether to protect yourself and your family or not, either. No vaccine is 100% effective, so an unvaccinated person puts even vaccinated persons at risk.

To help explain this irrational and downright dangerous behavior, I turn to an article by my personal security hero Bruce Schneier. In the context of the Conficker computer virus, Schneier discusses how humans deal with threats, information, and probability in general:

Generally, our brains aren’t very good at probability and risk analysis. We tend to use cognitive shortcuts instead of thoughtful analysis. This worked fine for the simple risks we encountered throughout most of our species’ existence, but it’s much less effective against the complex risks society forces us to face today.

For example, we tend to judge the probability of something happening based on how easy it is to bring examples of that thing to mind. It’s why people tend to buy earthquake insurance after an earthquake, although in reality that’s when the risk is the lowest. It’s why those of us who have been the victims of a crime tend to fear crime more than those who haven’t. And it’s why we fear a repeat of 9/11 more than we fear other types of terrorism.

We fear being murdered, kidnapped, raped, and assaulted by strangers, when friends and relatives are far more likely to do those things to us. We worry about airplane crashes instead of automobile crashes, which are far more common. In general, we tend to exaggerate spectacular, strange, and rare events, and downplay more ordinary, familiar, and common ones.

We also respond more to personal stories than to data. If I show you statistics on the crime rate in New York, you’ll probably shrug and continue your vacation planning. But if a close friend gets mugged on a trip there, you’re much more likely to cancel your trip.

And specific stories are more convincing than general ones. That is why we buy more insurance against airplane accidents than we do against travel accidents, or accidents in general. Or why, when surveyed, we are willing to pay more for airline travel insurance covering “terrorist acts” than “all possible causes.” That is why, in experiments, people judge specific scenarios as more likely than more general scenarios, even if the general ones include the specific.

McCarthy and Carrey probably don’t remember their friends dying of vaccine-preventable diseases when they were children because vaccines protected them. They remember their child’s diagnosis with autism quite vividly. These crusaders are even unapolagetic about the return of measles. As Ms. McCarthy so eloquently put it, “If you ask a parent of an autistic child if they want the measles or the autism, we will stand in line for the f___ing measles.”

Indeed, they are replacing a general threat with an unlikely, illogical specific one. Measles infected nearly 4 million people, chronically disabled 1,000, and killed nearly 500 a year before the vaccination program was introduced. It remains a top killer of children under five around the world. Influenza still causes more deaths a year than measles ever did, around 36,000 flu-related deaths occur each year. Most of those individuals were not vaccinated against the flu for whatever reason. According to the Autism Society of America only 1.5 million Americans total are living with autism and related disorders.

We do not know yet what causes autism. While tragic for parents and families at first, it remains non-fatal. On the other hand, we do know what causes numerous, potentially fatal infectious diseases. We know how to prevent these deaths, too. Vaccines.

Given people’s tendency to take anecdotal evidence more seriously than real evidence, I would respectfully request that Mr. Carrey go back to making his butt talk rather than pulling information out of, and talking from, it.

-Michael E. van Landingham

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You ignore the chronic and ongoing pain of life with a child with a spectrum disorder. It is never ending (as are the disabilities from preventable diseases.) These parents cannot leave their child, cannot easily hand over the burden to someone else and unlike a “simple” medical disability, can not find help to care for their children. In some states autism has strong advocates. Resources are provided to the families to alleviate some of their daily burden. In SC there are very few to no resources and families fail under the strain. Coupled with the other strains it is too much.

In my days in school, we learned of other cultures where malformed, diseased, or other non-functional or contributing individuals or infants were abandoned to die so as not to burden the community. I don’t advocate returning to that, but one does see the reality of why this was a viable choice.

Until we as a society embrace our co-humanity and understand that for every non-aborted child, autistic child or person of diminished capabilities to whom we refuse assistance whether that be from churches, neighborhoods or government, we diminish the future. If we prevent mercy killing by law and by societal covenant, then we as a citizenry, must embrace the result and provide community sustenance and support to all.

I realize and acknowledge that autism spectrum disorders (ASDs), Down’s syndrome, and the like are continuing disabilities who take their toll on families. I was not trying to ignore that fact, and I think I hint at it when I say that parents quite vividly remember their child’s diagnosis with a mental disability. For them, that is a much more real and greater tragedy than death from vaccine preventable infectious disease, something they have likely never witnessed.

We should offer greater support to these families, so they are not forced to turn to hucksters, charlatans, and confidence men who claim to be able to cure autism with any number of absurd, non-scientific treatments. It is largely this lack of support and the unidentified cause of ASDs that have led parents to unscientific conclusions in order to rationalize why it was their child who has to suffer. They should be able to get their child therapy and treatment.

They should not be able to agitate for people to stop vaccinating their children. That is a gigantic danger to public health, even more dangerous than autism, etc., as it would lead to epidemic disease. Especially since there is no link whatsoever (besides a correlation) between autism and vaccines.